Listado de medicamentos a evitar en atención primaria y su aplicación en pacientes polimedicados

Abstract

Introduction: The high prevalence of inappropriate medication use and its important health consequences for health require specific and agile tools to detect and avoid it. The objective of this work was to elaborate a list of medications to avoid in Primary Care and to apply it on the polymedicated patients of a Primary Care assistance service. Methods: In the Database of the Spanish General Council of Official Associations of Pharmacists (BOT-Plus) the status and availability of each of the 93 MAE of the Prescrire 2019 List was checked. The list of medications to be avoided in Primary Care was drawn up with those that were marketed in Spain and excluded those that were not financed and those for exclusive hospital use. With the list of medicines to avoid in Primary Care, a retrospective analysis was made of all the prescription reports of polimedicated >10 medications for 2017 in a Primary Care services (N=262) in 5 health centers. Frequency analysis, central tendency measures and dispersion were carried out; they were estimated [CI: 95%] and X or Fisher’s exact was used to determine the association between variables and logistic regression analysis. Results: A prevalence of polymedicated drugs of 1.2% was observed, with a mean age of 71.7 years (DT± 12.4) and a mean prescription of 12 drugs (DT±1.7). The list of medications to be avoided in PC included 45 active ingredients. The 50.4% of the polymedicated had at least one drug to avoid and an average age of 68.5 years (DT±11.8). Sex was a risk factor for inappropriate prescription, the fact of being a woman increases with an OR=1.8 (IC95%=1, 3-3.0) the probability of having some medicines to avoid. The most commonly used drugs to avoid were: duloxetine, sitagliptin and olmesartan. Conclusions: A high percentage of polymedicated patients are prescribed at least one drug to avoid. The Primary Care medication avoidance list is a useful tool for identifying inappropriate medication and for the use by Primary Care professionals